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Child Loan Agreement document sample
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Please print a copy of your completed form prior to closing the document as it cannot be saved. ECU BUSINESS SERVICES TEXTBOOK LOAN PROGRAM APPLICATION & LOAN AGREEMENT ECU-Dowdy Student Stores • (252) 328-6731 • 1-877-499-TEXT ECU EMPLOYEE INFORMATION LAST NAME (ECU EMPLOYEE) FIRST NAME (ECU EMPLOYEE) MIDDLE INITIAL DEPARTMENT/CAMPUS MAILING ADDRESS CAMPUS PHONE HOME PHONE HOME MAILING ADDRESS CITY, STATE, ZIPCODE EMAIL ADDRESS BANNER ID NUMBER APPROXIMATE DATE EMPLOYED BY ECU APPLYING FOR (check only one) FALL SPRING SUMMER I SUMMER II 11-WEEK SUMMER (separate application required for each term) STUDENT EDUCATIONAL STATUS (CHECK ALL THAT APPLY) UNDERGRADUATE STUDENT OR GRADUATE STUDENT DEGREE PROGRAM OR NONDEGREE STUDENT USING BOOKS INFORMATION LAST NAME (STUDENT USING BOOKS) FIRST NAME (STUDENT USING BOOKS) MIDDLE INITIAL FULL-TIME ECU EMPLOYEE WHO HAS COMPLETED PROBATION PERIOD SPOUSE DEPENDENT CHILD LOAN AGREEMENT CONSENT TO GARNISHMENT I understand that it is a privilege to participate in East Carolina University’s Business Services Textbook Loan Program and that my successful participation in the program will contribute to its continued success and to the ability of other University employees seeking to enhance their job skills or pursue educational goals. I agree to comply with the conditions of the ECU Business Services Textbook Loan Program and accept full responsibility for the textbooks loaned to me under the program. I agree that the textbooks will be returned in satisfactory condition and agree to return the textbooks within three business days following the final exam for each course, or immediately upon withdrawal from the course or separation from the university, whichever comes first. If the textbooks are not returned by the deadline or are not returned in a satisfactory condition, I agree to pay the full replacement costs for those textbooks. If I fail to pay for or to replace the textbooks by the established deadline, I understand that I will no longer be eligible to participate in the Textbook Loan Program and agree, by providing my signature below, that my wages may be garnished for the replacement costs. I understand that I may refuse to authorize garnishment of my wages and that, if I fail to meet my responsibilities to return the books or to pay the replacement costs for same, the university may pursue reimbursement under Chapter 143, Article 60 or other applicable provisions of the General Statutes of North Carolina. I understand that Chapter 143, Article 60 in Section 143-553(a) provides that if I owe money to the university because of my failure to return or reimburse the university for the books, I can be terminated from my university employment. I acknowledge that a copy of Chapter 143, Article 60 is printed on the reverse side of this form for my reference and review. I further acknowledge that I have read this entire Consent to Garnishment and the North Carolina statutes that are included herewith. I fully understand the Consent to Garnishment and the consequences to me, if I fail to return the loaned textbooks by the deadline or in a satisfactory condition, and I agree to be legally bound by this agreement. DECLARATION OF SPOUSE / CHILD DEPENDENT (Complete this section for Dependent Child / Spouse Book Loans Only) By signing this agreement I attest that the person named above as the student using these books is my (select one: spouse dependent child) and was indeed listed as a (select one: dependent child spouse) on my most recent tax return. Employee Signature _______________________________________________ Date ________________________ LOAN PROGRAM DEADLINES & REQUIREMENTS • This completed application along with a copy of your Complete Textbook Listing from OneStop AND a copy of your paid receipt for payment of classes from Banner or OneStop MUST be emailed to TEXTBOOKLOAN@ecu.edu or returned to the Dowdy Student Stores Main Campus location (Wright Building) or to the Medical Bookstore (Brody Building) by the posted deadline. Please refer to our web site: www.ecu.edu/cs-admin/studentstores/TextbookLoan (faculty/staff info) for more details. • If submitting paperwork close to the beginning of the term for which you are applying, please allow 3 business days to process before picking up books. • Loaned materials MUST be returned within 3 business days following the final exam for the course, or immediately upon withdrawal from the course, or separation from the university. BSM 07/09 Summary of Chapter 143, Article 60 Of the General Statutes of North Carolina Chapter 143, Article 60, in Section 143-553(a) of the General Statutes of North Carolina, provides that if you are employed by a State Agency and you owe money to the State, you must make full restitution of the amount you owe as a condition of your continued employment. East Carolina University is a state institution of higher education and a state agency. That means that if you owe money to the University and you fail to pay the money you owe, the University may take action to terminate your employment. However, you may not be terminated if there is a genuine dispute about whether you owe money to the State or how much money you owe to the State. Also, you may not be terminated if there is an unresolved issue concerning insurance coverage, or if you are pursuing administrative or judicial remedies to have the dispute or the issue resolved. Although you will not be terminated as long as you continue to make repayments to the State in good faith on a schedule agreed to by the University, the University may terminate you if you stop making payments. Section 143-554 provides you with the opportunity to appeal your termination to the State Personnel Commission according to the normal appeal and hearing procedures provided by Chapter 126 and the State Personnel Commission. You may wish to consult with the Employee Relations Officer at 328-0017 to fully understand your appeal rights and the deadlines that may apply for filing an appeal. Current ECU 1 Card and approved form required for merchandise pickup. RETURN LOANED MATERIALS WITHIN 3 BUSINESS DAYS FOLLOWING THE FINAL EXAM FOR THE COURSE, OR IMMEDIATELY UPON WITHDRAWAL FROM THE COURSE OR SEPARATION OF EMPLOYMENT FROM THE UNIVERSITY.